Telephone Triage Nurse, Elizabeth Hudson, outlines her experience in the relatively young nursing role, and highlights some of the challenges faced day to day.
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Having worked and thoroughly enjoyed my many years as an adult registered nurse in a busy hospital department, for reasons out of my control, the time came for a change and I made the transition to primary care.
Like many of us we almost become blinkered to anything outside our immediate work area and generally focus on our specific role in an attempt to be and do the very best we can.
Transitioning to primary care
Having never worked in primary care, I was unsure whether to even waste time applying as I doubted that I would be considered but, nothing ventured, nothing gained.
I was successful in my application so a completely new experience lies waiting for me and of course it was a trial period with no real longer-term job security offered.
As the practice had only been trialing the service for a few weeks, there was real scope to develop and progress this area.
It was both an eye opener and privilege to see and better understand how primary and secondary care can work to compliment each other, each being as important and critical as the other.
I have always offered loyalty and commitment in any role I have signed up to and I was adamant that, although this was going to be very different, I would give it everything I could.
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Constantly updating knowledge is vital
Within this role, constantly updating knowledge is vital as is excellent team working.
We rely on each other in so many ways and each appreciates that no one can know everything about everything, but rather, we each know something about something and together, we have a huge bank of knowledge and skills to draw on.
Other team members, from the reception team to the most senior GPs, are readily willing and available to offer support and advice as needed.
This was not always the case as initially there were lots of problems or rather, challenges, to over come.
An ever-developing job role
Initially, there were significant difficulties, most people don’t embrace change and this was definitely something I found in the early days.
There were some colleagues who resented the change and others who felt, unnecessarily, that this new role threatened their roles.
There were lots of teething problems and ongoing changes, in a real effort to make the role sustainable and accepted.
Many patients were very dissatisfied and did not hesitate to make their opinions known.
They definitely did not like the fact that having got through the reception team, they then needed to wait for a faceless person to call them and assess what was needed.
Trying to explain that “Triage” means “to sort” often fell on deaf ears and they wanted what they had always had.
It has been a slow but progressive process, requiring perseverance, patience with a welcoming understanding and empathetic approach to get patients to accept that what we offer is, a more efficient, effective and safe use of the service and facilities.
Most patients now accept that they will get a call back within the day from either a qualified nurse or GP though we cannot guarantee a time.
We will thoroughly assess them, their symptoms and concerns and allocate an appropriate follow up either as a face to face appointment or other services as appropriate.
For some patients, we are now the friendly voice on the phone who will make time just to listen and why?
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One thing I have really missed is the face to face contact
One thing I have really missed is the face to face contact with patients.
Having worked in a busy specialist outpatient clinic where, regular reviews and getting to know patients was so much of what I enjoyed, the change to making telephone assessments without the benefit of body language has been very hard.
I would advise anyone, to not underestimate the usefulness of body language that can, so often, give more information than words ever will.
Patients are whole beings and we must never forget, in the business of life, the importance of each part that makes the whole.
There were suggestions that I could be involved in clinics.
However, due to the difficulty in recruiting staff to telephone triage roles, this has never happened.
I do feel that within this specific role, especially if covering full days, progression is rather limited, unless there is a team who cover the tel triage side thereby accommodating each other in doing other roles within the practice, but this has not been my experience.
A valuable experience
Despite my colleague’s initial comments about how long I would stay, I have been here almost 5 years.
Although physically, it is not a difficult role, emotionally and mentally it really can be tough.
If you think perhaps this area of work is not for you, I would advise “Never say never”.
The experience is valuable even if, at times, you perhaps don’t feel you are as valued as maybe you should be.